Introduction:
This project took over 6 month of preparation.
I felt that every step in that project needed to take its time and not to be rushed. This project is across multiple specialties and has the potential of expanding both in the variety of cases that can be included and in geographical area that can cover (aim of trust wide application).
The benefit on improving patient care and ED time and fracture clinic appointments is huge. There are lots of similar injuries that can be managed by the one stop shop service. I am hoping that this project will be the start of a significant service transformation which aim at higher, improved , modern quality service that will affect a lots of minor injury patients.
Aim:
To standardise management of simple fracture starting with:
1. Fracture base 5th MC in adults
2. Fracture clavicle in children (younger than 11 yrs.)
3. Buckle fracture
Objectives:
• Minor injury unit being able to manage these fractures and discharge with advice
• Patient education of self-care
• To standardise this management pan Trust
Measures:
• Guidance note to A&E regarding management
• Patient leaflet for self-care
• Monitoring through keeping patient list and reviewing x-ray weekly
• Monitoring progress and identifying problems in supply
• Business as usual is the final outcome
What have I done:
• Literature search regarding the management of these fractures (excellent effort done by the ULHT Library Team) including other trusts with similar protocols
• Engaging with Mr T Southorn (paediatric orthopaedic consultant) and Mr C Corbin (hand and upper limb orthopaedic consultant) regarding management plan and leaflet design
• Department approval of the management plan
• Communication with A&E clinical director regarding training
• Leaflets draft submitted to reading panel
Tools used:
• Training sessions to minor injuries staff
• Identify problems with supply
• Monitor management by weekly review of x-rays
• Monitor progress collecting data on wrong diagnosis fracture clinic turnout
• Doing an audit after business as usual level is reached
Results:
Results will be presented at Orthopaedic department Audit meeting in May 2019
Next steps:
• To apply this management trust wide
Update:
We are now have orthopaedic department and ED department at Lincoln on board, patients leaflet are all ready, we have a provisional starting date 1st of June and we are now in the stage preparing of advertising for it on social media to prepare the public for it.
Mr Mohamed Elmeligy, Trauma and Orthopaedics